Abstract
BackgroundEvidence on the association between exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) and blood glucose concentrations in pregnant women is inconsistent. This study aimed to examine the association between PFAS exposure and the concentrations of fasting plasma glucose (FPG) and one-hour plasma glucose (1 h-PG) after a 50-g oral glucose tolerance test in pregnant women.MethodsThe study was based on the Shanghai-Minhang Birth Cohort, in which 1292 pregnant women were recruited. Among them, 981 women provided blood samples (at 12–16 gestational weeks) for PFAS measurement. FPG data collected from 856 women at 12–20 GW and 1 h-PG data collected from 705 women at 20–28 GW were obtained through medical records from the routine prenatal care system. High FPG or 1 h-PG was defined as ≥90th percentile of FPG or 1 h-PG. The analysis of eight PFASs was conducted in this study: perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), perfluorodecanoic acid (PFDA), perfluoroundecanoic acid (PFUdA), perfluorododecanoic acid (PFDoA), and perfluorotridecanoic acid (PFTrDA). The odds ratios (ORs) and associated 95% confidence intervals (CIs) were estimated to determine the associations of each PFAS compound with high FPG and 1 h-PG from a logistic regression model.ResultsAfter adjustment for potential confounders, most PFASs were positively associated with high 1 h-PG concentrations. The OR for high 1 h-PG concentrations was 1.87 (95% CI: 1.15–3.05) with a one log unit increase of PFOS; similar associations were observed for PFNA (OR: 2.15, 95% CI: 1.24–3.74), PFDA (OR: 1.61, 95% CI: 1.10–2.44), PFUdA (OR: 1.71, 95% CI: 1.12–2.62), and PFDoA (OR: 1.34, 95% CI: 1.00–1.81). When the PFAS concentrations were categorized into three groups by tertiles, the highest tertiles of PFOS, PFOA, PFNA, PFDA, PFDoA, and PFTrDA had a statistically significant increase in the risk of high 1 h-PG concentrations compared with the lowest tertiles. No statistically significant association was observed between PFAS exposure and high FPG.ConclusionPFAS exposure was associated with an increased risk of high 1 h-PG among pregnant women, but no such association was observed for FPG.
Highlights
Perfluoroalkyl and polyfluoroalkyl substances (PFASs), a group of man-made chemicals with water, stain, and grease-resistant properties, are used in a wide range of consumer products, including fast food packaging, stainresistant carpets, windshield washing fluid, fire-fighting foam, insecticides, and paints [1]
Pregnant women attending their first routine antenatal care at the Maternal and Child Health Hospital of Minhang district in Shanghai were consecutively recruited if: 1) they were at 12–16 gestational weeks (GW) of pregnancy; 2) they were registered residents of Shanghai; 3) they had no history of chronic disease of the liver, kidney, or other organs; 4) they planned to give birth in the study hospital; and 5) they were willing to participate in specified interviews during pregnancy and after delivery
Among the 11 PFASs measured in our study, eight PFASs with detection rates above 90%, including perfluorohexane sulfonate (PFHxS), perfluorooctane sulfonate (PFOS), PFOA, PFNA, perfluorodecanoic acid (PFDA), perfluorododecanoic acid (PFDoA), perfluoroundecanoic acid (PFUdA), and perfluorotridecanoic acid (PFTrDA), were included in the final analyses
Summary
Perfluoroalkyl and polyfluoroalkyl substances (PFASs), a group of man-made chemicals with water-, stain-, and grease-resistant properties, are used in a wide range of consumer products, including fast food packaging, stainresistant carpets, windshield washing fluid, fire-fighting foam, insecticides, and paints [1]. Animal studies have shown that PFAS exposure is associated with a wide range of adverse health effects, including the disruption of endocrine hormones, such as testosterone, estrogen, and thyroid hormones [7, 8], alterations in serum lipid levels [9], impaired glucose metabolism and insulin hypersensitivity [10], and immune system disturbance [1, 9]. Evidence on the association between exposure to perfluoroalkyl and polyfluoroalkyl substances (PFASs) and blood glucose concentrations in pregnant women is inconsistent. This study aimed to examine the association between PFAS exposure and the concentrations of fasting plasma glucose (FPG) and one-hour plasma glucose (1 h-PG) after a 50-g oral glucose tolerance test in pregnant women
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